Hepatocellular carcinoma (HCC), also known as malignant hepatoma, is the most common primary malignancy of the liver and accounts for 80-90% of primary liver tumors. HCC is one of the most common and devastating malignant diseases worldwide, responsible for more than 1 million deaths annually in the world (Parkin et al., CA Cancer J. Clin. 1999, 49, 33-64; Bruix et al., Cancer Cell 2004, 5, 215-219).
The major risk factors for the development of HCC include hepatitis B or C viral infection, and alcoholic liver disease (Rustgi, Gastroenterol. Clin. North Am. 1987, 16, 545-551; Bosch et al., Semin. Liver Dis. 1999, 19, 271-285; Bosch et al., Gastroenterology 2004, 127, S5-S16; Moradpour et al., Eur. J. Gastro & Hepatol. 2005, 17, 477-483; Koike et al., J. Gastroenterol. Hepatol. 2008, 23, S87-S91; de Oliveria Andrade, J. Glob. Infect. Dis. 2009, 1, 33-37). HCC arises most commonly in cirrhotic livers following infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) (Liaw, Semin. Liver Dis. 2005, 25, 40-47; Koike Clin. Gastroenterol. Hepatol. 2005, 3, 132-135). HCC is associated with HBV infection in about 50% of cases (Liaw, Semin. Liver Dis. 2005, 25, 40-47). HCV infection is the cause of 70% of the cases of HCC in Japan (Hasan, et al., Hepatology, 1990, 12:589-591; El-Serag et al., N. Engl. J. Med. 1999, 340, 745-750). The HCC incidence has been increasing in Western countries in recent years due to the spread of hepatitis C virus (HCV) infection (El-Serag, Hepatology 2002, 36, S74-83; Trevisani et al., Carcinogenesis 2008, 29, 1299-1305).
Hepatocellular carcinoma is a disease of worldwide significance, of which there is no truly effective therapy, particularly for advanced disease. Therefore, there is a need for biomarkers to aid a HCC treatment and a method of predicting the responsiveness of a HCC patient to a HCC treatment, e.g., chemotherapy.